Professional Documents
Culture Documents
Personal Data Sheet
Personal Data Sheet
212
Revised 2017
I. PERSONAL INFORMATION
2. SURNAME LEE
NAME EXTENSION (JR., SR)
FIRST NAME ANN
9. BLOOD TYPE 0
18. PERMANENT ADDRESS 063 Guadayan
House/Block/Lot No. Street
Puguis
10. GSIS ID NO. 2005536995
Subdivision/Village Barangay
15. AGENCY EMPLOYEE NO. 21. E-MAIL ADDRESS (if any) lee.mae@gmail.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME N/A 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR) N/A
FIRST NAME N/A N/A
OCCUPATION N/A
SURNAME BERNARD
SECONDARY
VOCATIONAL / BENGUET NATIONAL HIGH SCHOOL 2006 2010 2010 N/A
LICENSURE EXAMINATION FOR TEACHERS 80% 12/12/2015 BAGUIO CITY 456897 11/20/2021
DEPARTMENT OF EDUCATION-BENGUET
01/01/2019 01/31/2019 ADMINISTRATIVE AIDE VI
DIVISION
14,847.00 SG 6-0 PERMANENT YES
DEPARTMENT OF EDUCATION-BENGUET
11/12/2018 12/31/2018 ADMINISTRATIVE AIDE VI
DIVISION
14,340.00 SG 6-0 PERMANENT YES
SOCIAL WELFARE AIDE -GENDER AND MUNICIPAL SOCIAL WELFARE & DEVELOPMENT
01/10/2018 11/10/2018 9,121.00 N/A JOB ORDER NO
DEVELOPMENT (GAD)- ENCODER OFFICE/LOCAL GOV'T UNIT OF KAPANGAN
SOCIAL WELFARE AIDE -PERSONS WITH MUNICIPAL SOCIAL WELFARE & DEVELOPMENT
01/09/2017 12/31/2017 9,121.00 N/A JOB ORDER NO
DISSABILITY AFFAIRS CLERK/ENCODER OFFICE/LOCAL GOV'T UNIT OF KAPANGAN
MUNICIPAL COORDINATING TEAM-COMMUNITY MUNICIPAL SOCIAL WELFARE & DEVELOPMENT
02/16/2016 12/31/2016 EMPOWERMENT FACILITATOR OFFICE/LOCAL GOV'T UNIT OF KAPANGAN
9,121.00 N/A JOB ORDER NO
Seminar-Workshop on the Property and Supply Management (Inventory to Disposal) 03/13/2019 03/15/2019 24 Technical Department of Education -Benguet Division
Workshop on updating the Plantilla of Personnel of Schools and School Division Offices 06/05/2019 06/05/2019 16 Technical Department of Education -Benguet Division
Division Induction Training for Newly Hired Non-Teaching Employees 02/09/2019 04/09/2019 24 Technical Department of Education -Benguet Division
Engendering Extension Program and Projects:The Harmonized GAD Guidelines (For Project Agricultural Training Institute -Cordillera Administrative
05/22/2018 05/24/2018 24 Technical
Development ,Implementation,Monitoring and Evaluation) Region
Social Welfare Development Forum 03/04/2018 03/05/2018 12.5 Technical Department of Social Welfare and Development
Peoples Initiative for Learning and Community
Workshop on Dissability Inclusive Disaster Risk Reduction and & Management (DI-DRRM) 02/07/2018 02/09/2018 24 Technical Development /Canada Fund for Local Initiatives in
PeoplesPartnership
Initiative forwith Canada
Learning andFund
Community
Disability Inclusive Development (DID) Workshop 11/22/2017 11/24/2017 24 Technical Development /Canada Fund for Local Initiatives in
Learning and Development Intervention for Local Social Welfare and Development Offices Partnership with Canada Fund
Functionality Track 3: Pre-mariage Counseling ,Child in Conflict with the Law and Early 10/24/2017 10/26/2017 24 Technical Department of Social Welfare and Development
Childhood Care and Development
Learning and Development Intervention for Local Social Welfare and Development Offices
09/05/2017 09/07/2017 24 Technical Department of Social Welfare and Development
Functionality Track 2: Strnegtening Social Welfare and Development Sectors in the Cordillera
ASEAN MULTI-SECTORAL FORUM 06/30/2017 06/30/2017 8 Technical Provincial Capitol -Province of Benguet
KCNCDDP REFRESHER COURSES FOR THE AREA AND MUNICIPAL COORDINATING TEAM
03/06/2017 03/10/2017 40 Technical Department of Social Welfare and Development
CYCLE 3
b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘
35. a. Have you ever been found guilty of any administrative offense? YES ✘ NO
If YES, give details:
________________________________
________________________________
b. Have you been criminally charged before any court? YES ✘ NO
If YES, give details:
________________________________
Date Filed:
________________________________
Status of Case/s:
36. Have you ever been convicted of any crime or violation of any law, decree, ordinance or regulation
by any court or tribunal?
YES ✘ NO
If YES, give details:
________________________________
________________________________
37. Have you ever been separated from the service in any of the following modes: resignation, YES ✘ NO
retirement, dropped from the rolls, dismissal, termination, end of term, finished contract or phased If YES, give details:
out (abolition) in the public or private sector? ________________________________
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year (except
YES ✘ NO
Barangay election)?
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before the last YES ✘ NO
election to promote/actively campaign for a national or local candidate? If YES, give details:
39. Have you acquired the status of an immigrant or permanent resident of another country?
YES ✘ NO
If YES, give details (country):
40. Pursuant to: (a) Indigenous People's Act (RA 8371); (b) Magna Carta for Disabled Persons (RA
7277); and (c) Solo Parents Welfare Act of 2000 (RA 8972), please answer the following items:
a. Are you a member of any indigenous group? ✘ YES NO
If YES, please specify: KANKANA-EY
b. Are you a person with disability? YES ✘ NO
If YES, please specify ID No:
c. Are you a solo parent? YES ✘ NO
If YES, please specify ID No:
ID/License/Passport No.:
Signature (Sign inside the box)
Date/Place of Issuance:
Date Accomplished Right Thumbmark
SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated above.